Quality statement 5: Discussion with a nephrologist

Quality statement

People with acute kidney injury have the management of their condition discussed with a nephrologist as soon as possible, and within 24 hours of detection, if they are at risk of intrinsic renal disease or have stage 3 acute kidney injury or a renal transplant.

Rationale

Input from nephrologists to the management of acute kidney injury is needed as soon as possible for people who are at risk of their condition worsening or of adverse outcomes. This helps to ensure that people get the specialist care they need to help their condition improve and to prevent it from deteriorating further.

Quality measures

Structure

Evidence of local arrangements to ensure that people with acute kidney injury who are at risk of intrinsic renal disease or have stage 3 acute kidney injury or a renal transplant have the management of their condition discussed with a nephrologist as soon as possible and within 24 hours of detection.

Data source: Local data collection.

Process

Proportion of presentations of people with acute kidney injury who are at risk of intrinsic renal disease or have stage 3 acute kidney injury or a renal transplant where management is discussed with a nephrologist within 24 hours of detection.

Numerator – the number in the denominator where management is discussed with a nephrologist within 24 hours of detection of acute kidney injury.

Denominator – the number of presentations of people with acute kidney injury who are at risk of intrinsic renal disease or have stage 3 acute kidney injury or a renal transplant.

Outcomes

What the quality statement means for service providers, healthcare professionals, and commissioners

Service providers (district general hospitals) ensure that the management of acute kidney injury for people who are at risk of intrinsic renal disease or have stage 3 acute kidney injury or a renal transplant is discussed with a nephrologist or paediatric nephrologist as soon as possible, and within 24 hours of detection.

Healthcare professionals discussthe management of acute kidney injury for people who are at risk of intrinsic renal disease or have stage 3 acute kidney injury or a renal transplant with a nephrologist or paediatric nephrologist as soon as possible, and within 24 hours of detection.

Commissioners (clinical commissioning groups) ensure that secondary care providers have protocols in place so that the management of acute kidney injury for people who are at risk of intrinsic renal disease or have stage 3 acute kidney injury or a renal transplant is discussed with a nephrologist or paediatric nephrologist as soon as possible, and within 24 hours of detection.

What the quality statement means for patients, service users and carers

People with acute kidney injury who are at risk of kidney disease or have stage 3 acute kidney injury or a kidney transplant have their condition discussed with a specialist as soon as possible (within 24 hours at most), so that they get the right treatment.